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Circulation：高敏性血浆肌钙蛋白I（hs-TnI）对普通人群心脏病风险的预测价值

2019-06-07 QQ MedSci原创

高敏性血浆肌钙蛋白Ihs-TnI心脏病
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高敏感性试验(hs-TnI)测定的血浆肌钙蛋白I是否与未发生过CVD的社区人群突发心血管疾病(CVD)的发生率和死亡率有关？ARIC研究在8121位既往无CVD的54岁-74岁的普通人群中研究hs-TnI与冠心病（CHD；心肌梗死和致命性CHD）、缺血性脑卒中、动脉粥样硬化CVD（CHD和卒中）、心衰住院和整体CVD（动脉粥样硬化CVD和心衰）以及全因死亡率的关系。中位随访15年。获得了85%的研

高敏感性试验(hs-TnI)测定的血浆肌钙蛋白I是否与未发生过CVD的社区人群突发心血管疾病(CVD)的发生率和死亡率有关？

ARIC研究在8121位既往无CVD的54岁-74岁的普通人群中研究hs-TnI与冠心病（CHD；心肌梗死和致命性CHD）、缺血性脑卒中、动脉粥样硬化CVD（CHD和卒中）、心衰住院和整体CVD（动脉粥样硬化CVD和心衰）以及全因死亡率的关系。

中位随访15年。获得了85%的研究个体的hs-TnI，与低hs-TnI（hs-TnI ≤1.3 ng/L）相比，高hs-TnI（≥3.8 ng/L）与CHD（风险比[HR] 2.20，95% CI 1.64-2.95）、缺血性脑卒中(HR 2.99； 95% CI， 2.01–4.46) 、动脉粥样硬化CVD(HR 2.36； 95% CI， 1.86–3.00)、心衰住院 (HR 4.20； 95% CI， 3.28–5.37)、整体CVD (HR， 3.01； 95% CI， 2.50–3.63)和全因死亡(HR， 1.83； 95% CI， 1.56–2.14)的发生率升高相关。白种人hs-TnI与整体CVD发生率的关联强于黑种人，女性hs-TnI与与CVD发生率的关联强于男性。hs-TnI与高敏感肌钙蛋白T仅有中度的相关性（r=0.47），在预测CVD事件方面互补；两者同时升高与单独一个升高相比，风险最大。将hs-TnI加入汇总队列方程模型中可改善动脉粥样硬化性CVD、心衰和整体CVD的风险预测。

在普通人群中，高hs-TnI与整体CVD发病率升高有很强的相关性，而且独立于传统风险因素。hs-TnI与高敏感肌钙蛋白用于预测CVD/CHD风险时可相互补充。

原始出处：

Xiaoming Jia ， Wensheng Sun，et al. High-Sensitivity Troponin I and Incident Coronary Events， Stroke， Heart Failure Hospitalization， and Mortality in the ARIC Study. 4 Jun 2019https：//doi.org/10.1161/CIRCULATIONAHA.118.038772Circulation. 2019；139：2642–2653

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